The Health and Adult Social Care Scrutiny Committee were scheduled to meet to discuss a number of topics, including a proposal to enter into a new Section 75 agreement¹ with North East London Foundation Trust (NELFT), and proposed changes to the Minimum Income Guarantee uplift. The committee was also expected to review the draft forward plan for the 2025/26 municipal year.

Fairer Contributions Policy: Proposal for Changes to Minimum Income Guarantee Uplift

The committee was scheduled to discuss a report on the proposed changes to the Fairer Contributions Policy, specifically the reduction and removal of the 25% discretionary uplift applied to the national Minimum Income Guarantee (MIG).

The report noted that on 6 May 2025, the cabinet agreed to consult on the proposal to review the Fairer Contributions Policy. The council carried out a 12-week public consultation between 22 May 2025 and 13 August 2025 to gather feedback on the proposal. According to the report, the consultation approach included:

• Commissioning Public Perspectives to host and manage the consultation platform and conduct the final analysis.
• Sending direct mail to over 2,500 service users and their representatives, outlining the proposals and available support.
• Providing consultation documents in Easy Read and other accessible formats.
• Publishing a frequently asked questions document online to improve accessibility.

The report stated that the council received 109 responses, representing 4.23% of individuals engaged regarding the proposal. Of those who responded:

• 61% strongly disagreed, with a further 8% tending to disagree.
• 11% of respondents agreed or tended to agree with the proposal
• 65% of respondents anticipated a negative impact

According to the report, when asked about alternative proposals, 53% preferred no change, maintaining the current 25% uplift.

The report stated that if the proposal is implemented, the financial impact on individual residents will vary depending on income, care package, and current contribution levels. The potential financial impacts have been modelled based on data from 2791 current service users:

• 48% (1345) are unlikely to see a change to their current contributions
• 41% (1145) may see an increase to their contributions.
• 11% (300) could begin contributing for the first time.

The report also included a proposed package of mitigations to ensure that those most affected are able to receive appropriate support. These measures include:

• Inclusive communication and community-based engagement
• Targeted financial support and outreach using the LIFT platform
• Access to financial support via the Local Welfare Assistance Scheme

The report recommended that the committee review the information within the report, ask questions, and make recommendations as required.

Section 75 Agreement for the Delivery of Integrated Services for People with a Mental Health Need

The committee was scheduled to review a decision under consideration at Cabinet on 4 November 2025, regarding the proposal to enter into a new Section 75 Agreement under the National Health Services Act 2006 with NELFT. The agreement aims to support the delivery of integrated services for residents with mental health needs who meet the eligibility criteria under the Care Act 2014². The current agreement between NELFT and the London Borough of Waltham Forest is due to expire 31 January 2026. The new agreement is proposed to commence from 1 February 2026 for a fixed term of five years, incorporating annual break options.

According to the report, from April to July 2025, a review of the current Partnership was undertaken to inform the proposed continuation of the Section 75 Agreement from 1 February 2026 and consider the future Operating Model for the Partnership. The review provided an assessment of how the Partnership is delivered from the perspectives of staff at all levels working within the integrated teams and opportunities, to strengthen the model moving forward.

The report stated that the new agreement will build on the positive work that has taken place over the last fifteen years of joint-working and will incorporate a series of improvements shaped by the recent review in order to strengthen outcomes for individuals and, incorporate the ambitions set out in the NHS 10 Year Health Plan for England as well as Mission Waltham Forest.

The report noted that the Council and NELFT identified key areas for improvement and development which include:

• Clarifying roles and responsibilities within the wider mental health teams.
• Mapping out mental health pathways.
• Strengthening links with the primary care offer and crisis provision in practice.
• Establishing and agreeing ways to measure person centred outcomes, moving beyond quantitative data for example incorporating the Open Dialogue Model.
• Agreeing the partnership definition of what 'Good' looks like and how to achieve and measure the 'Good'.
• Acknowledging that new integrated services are critical to building care holistically around the needs of the person, to improve their outcomes and support them to achieve wellbeing.

The report also included an Equalities Impact Assessment and a Section 75 Partnership Agreement Consultation.

The report recommended that the committee review the information within the report, ask questions of witnesses and make recommendations as required.

The Scrutiny Report

The committee was scheduled to review the draft Forward Plan for the 2025/26 municipal year and make recommendations as necessary. The committee was also expected to review and comment on the Action Tracker and Recommendation Tracker from the previous meetings and any additional responses.

The report included a draft forward plan, which outlined the work programme for the committee, factoring in statutory reports, major decisions, themed reviews where appropriate, and policy areas of interest to the committee.

The report also included an action tracker, which captures all actions required of officers by the committee at the previous scrutiny meeting and provides an update on progress.

The report included a recommendation tracker, which captures all recommendations made by the committee at the previous scrutiny meeting.